When the immune system suddenly sounds the alarm, when it attacks small and later larger joints, bones and organs for no reason, the diagnosis is often: rheumatism. Until now, many patients have had to be content with the statement that nothing can be done about rheumatism. Professor Andreas Radbruch, Scientific Director of the German Rheumatism Research Center in Berlin, explains: “With today’s drugs, we only fight the symptoms. Once patients discontinue them, destruction progresses. Because the immune system remembers the rheumatism.” The basis of the memory is the immunological memory. Normally it is supposed to protect us from diseasesprotect that we have already survived once in life. But with rheumatism it’s different. In the case of rheumatism, it is precisely this memory that is responsible for the progression of the disease.
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When helper cells attack their own tissue
Our defense system is constantly and incessantly in use. Throughout our lives, it has to deal with tons of pathogens. In order to fight bacteria and viruses as quickly as possible, it develops a memory. A group of so-called T-helper cells, which specializes in memory, is responsible for this. They store characteristics of bacteria and viruses. T-helper cells are persistent: they never forget who they recognize as an enemy. Again and again they fight this enemy. That doesn’t work for rheumatism. There they have misunderstood their task and turn against the body’s own tissue.
unmask outliers
In order to correct the memory of the immune system in such cases, Professor Radbruch’s team has now developed a subtle method: a biomarker called “Twist1” makes it possible to unmask immune cells that have gone out of control. Cell therapy removes the misguided cells from the body with pinpoint accuracy. The intact defense cells remain untouched and can continue to exercise their protective function. The cause of rheumatism would be eliminated, the patient would be cured!
Perspectives for therapy and prevention
Experiences with patients suffering from particularly aggressive rheumatic diseases confirm a chance of success with the same principle on which the therapy is based. Her immune system was first completely destroyed with chemotherapy and then rebuilt with stem cells. It corresponds to that of a baby, knows absolutely no germs. The vaccination protection is also lost. Radbruch: “Two thirds of the patients have healed since the treatment.” There is one problem with the whole thing: the risks are considerable. Because between the erasure of the old and the construction of the new immune system, the risk of infection is extremely high. The radical method, which costs around 50,000 euros, is therefore considered the last resort to save lives.
Fewer risks than before
The new biomarker now promises a more subtle approach with fewer side effects, the immune protection is retained – a causal therapy on a broader front. “The hope is that we will soon be able to tailor the treatment to the individual patient,” says Professor Radbruch. Even more important than the form of treatment is the early start of therapy. Joint damage can already be prevented in 80 percent of cases with the usual means, provided that the therapy begins in the first few months. But on average, people with rheumatism only see a rheumatologist after a year and a half. They receive the necessary medication too late. Deficits are also evident in ergotherapy or patient training. Radbruch: “Even if rheumatism has not yet been cured or completely stopped,
